Analysis of Multistage Pooling Studies of Biological Specimens for Estimating Disease Incidence and Prevalence
Article first published online: 26 MAY 2004
Volume 55, Issue 2, pages 608–612, June 1999
How to Cite
Brookmeyer, R. (1999), Analysis of Multistage Pooling Studies of Biological Specimens for Estimating Disease Incidence and Prevalence. Biometrics, 55: 608–612. doi: 10.1111/j.0006-341X.1999.00608.x
- Issue published online: 26 MAY 2004
- Article first published online: 26 MAY 2004
- Received July 1997. Revised February 1998. Accepted June 1998.
Summary. The testing of pooled samples of biological specimens for the purpose of estimating disease prevalence may be more cost effective than testing individual samples, particularly if the prevalence of disease is low. Multistage pooling studies involve testing pools and then sequentially subdividing and testing the positive pools. A simple estimator of disease prevalence and its variance are derived for general multistage pooling studies and are shown t o be natural generalizations of Thompson's (1962) original estimators for single-stage pooling studies. The reduction in variance associated with each additional stage is calibrated. The results are extended to estimating disease incidence rates. The methods are used to estimate HIV incidence rates from a prevalence study of early HIV infection using a PCR assay for HIV RNA.